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There are a lot of things to consider if you are going to go into private practice as a pre-licensed clinician.You may first think about things such as fee splits, entity formation, and which supervisor to choose. That's totally normal (and all important stuff) but here are some things that any pre-licensed clinician can do BEFORE they start their private practice.

If you are considering going into private practice here are some top tips to get started.

The road to licensure is a long and windy road! Well, it just took another turn. We are now entering new territory and it’s called the 2016 EXAM RESTRUCTURE!! With new exams, new format and time frames. HERE WE GO… Get your seatbelts on and get ready for the ride!

Did you know that sometimes people get it wrong? It happens... all the time. I was doing research on another pre-licensed topic and realized- I was out of the loop! I had a piece of information stuck in my head that was no longer accurate. Thankfully nobody had asked me this particular question in awhile, but it could've happened and I would have probably confidently answered the question- and I would've been wrong.

Wherever you are in your licensing process- whether you are supervising others, or just starting your path as a student, I want to share with you some tips to stay on top of the most accurate information.

Tip #1: Get to know your state board website

Each state in the United States, yes all 50 of them have at least one website where they share the laws and regulations that relate to mental health providers. If you live in one state and are going to school in another. Or, if you are going to school in one state and plan to relocate to another- I recommend you get to know BOTH websites. Bookmark those babies. And, if there is an option- like in California- to have updates emailed to you- subscribe to it.

Tip #2: Read the updates

I know it can be overwhelming to navigate these websites. Many of them aren't user friendly. Even if they are user friendly- these websites are extensions of legislation. And, let's face it, legislation or laws are not known for being streamlined and succinct. This is your career, swallow that bitter pill and start reading these laws and FAQs, send in questions and start getting really informed. Don't rely on supervisors, or even your professional organization to tell you exactly what needs to happen.

Tip #3: Keep your records

Have a spot where you keep track of the changes and shifts. You don't have to be perfect, but have a clear spot to look for the information you need. While you are at it- be sure to keep your syllabus, hours collection, and university catalog handy in that same spot. If you ever plan to move from one state to another- you might be surprised at what data you will need to provide!

So, are you wondering what update I missed? In California, as of January 2013- you can gain hours of credit for workshops, and trainings- with your supervisor's approval in a week where you didn't get supervision. Not a huge change for sure. But this change makes SO much more sense! It always felt odd to me as a supervisor. If I send my intern or trainee to a week long training they can't count it because I wasn't there with them?

Anyways- share your tips for staying up to date with the laws and changes in your state in the comments below!

I have successfully built a cash pay psychotherapy practice from scratch on
a shoestring budget. I have also failed a licensed exam by 1 point (only to
have the licensing board send me a later months later saying I passed),
started an online study group to ease my own isolation and have now reached
thousands of therapists across the country, helped other therapists market
their psychotherapy practices, and helped awesome business owners move from
close to closing their doors, to being profitable in less than 6 weeks.
I've failed at launching online programs. I've had wild success at
launching online programs. I've made mistakes in private practice I've
taught others how to avoid my mistakes. You can do this. You were called to
this work. Now- go do it! Find some help or inspiration as you need it- but
do the work!

There are times when I wonder why I do all this. Times when I get overwhelmed or even feel cranky after having done this work for so long. It is hard to see the same issues continue for so long and not see changes to the system. Then, I get emails like this... and it truly makes my day. This is why I write this blog. This is why I continue to put myself out there. This is what makes it all worth it!

"Hi Miranda-

First I want to say thank you again for your news letter and blog. It has really helped me to keep my eye on the prize. I finished my masters in December and figured that there were going to be no opportunities or at least limited opportunities for me as a trainee awaiting my intern number. I thought retail was imminent.

I remembered reading your blog where you said that a lot of interns go around crying that their are no jobs that pay and that some are getting multiple interviews. This was my second week sending applications and I am so encouraged to say, that as of today, I have FIVE interviews all for positions that pay.

I also was able to apply for the MFT consortium stipend program which I did get for $18,500. I did not send this to toot my own horn. I just want to echo to interns that it is not that bleak out there and with a little creativity and a positive outlook I think we can all make it to licensure.

Again thank you for encouraging people in my position to fight the good fight.

Happy New Year!"

What would this person have done if they didn't think a job was possible? I LOVE it when we have truth in front of us- and it keeps us motivated to do what needs to be done. Get out there pre-licensed therapists- I won't promise it will be easy- but I can promise it will be worth it!

I have successfully built a cash pay psychotherapy practice from scratch on
a shoestring budget. I have also failed a licensed exam by 1 point (only to
have the licensing board send me a later months later saying I passed),
started an online study group to ease my own isolation and have now reached
thousands of therapists across the country, helped other therapists market
their psychotherapy practices, and helped awesome business owners move from
close to closing their doors, to being profitable in less than 6 weeks.
I've failed at launching online programs. I've had wild success at
launching online programs. I've made mistakes in private practice I've
taught others how to avoid my mistakes. You can do this. You were called to
this work. Now- go do it! Find some help or inspiration as you need it- but
do the work!

1. If you’ve been letting your self-care slide, these exams will force you eye-to-eye with how much you’re NOT doing what you teach your clients. In these exams it doesn’t matter if you can memorize gobs of stuff or whether you were a good test taker in school. These exams are about whether you can manage your anxiety and make well-reasoned decisions while enduring uncertainty. Which, face it, is what our profession requires from us on a fairly regular basis. If your “tank” is on empty because you haven’t been taking care of yourself that will limit your ability to do well on these tests. Therefore, use this time not only to study but to reevaluate the current balance of your life.

2. These exams will bring you eye-to-eye with the misinformation you’ve picked up over the years from professors and supervisors who don’t take the time to stay current with professional guidelines. The license you will be issued is precious, and these exams make it clear what you need to know and do to make sure you never lose that precious commodity. Passing these exams means you’ve been launched into your licensed career with the most up-to-date legal and ethical guidelines – now it’s up to you to maintain them.

3. These exams are a big deal. And everything that comes after taking and passing them is ALSO a big deal. You’ll be licensed and as such have options available to you. The “goal” of getting licensed has now turned into a crossroads. What do you do with the wide open space spreading before you? Taking and passing these exams builds your confidence. Taking and passing these exams lets you know that you have what it takes to forge ahead. Taking and passing these exams gives feet to your dreams.

4. Taking and passing these exams isn’t possible without support. If you haven’t learned the importance of networking yet, you will learn it now. You need a network of colleagues whom you can count on for information and encouragement. That same network will be there on the other (licensed) side when you’re looking for a well-paying job, starting a private practice, building a non-profit… The relationships you build and maintain with your peers while you’re walking through this crucible together is VALUABLE.

5. Finally, taking and passing these exams is a rite of passage that inserts you into a top notch group of people who not only say they want to help to make the world a better place, but have actually put their time, money, sweat, and tears toward that goal. It means you’ve come through the tests, papers, theses, comps, field experiences, pratica, internships, personal therapy, late nights, low pay, and, yes, 2 seriously kick-butt exams in order to stand by your values. You ARE a Licensed Marriage and Family Therapist!

Angela French is a licensed marriage and family therapist, and is making her dream of private practice in Manteca, California a reality. Angela loves working with women who care deeply about others but are losing their sense of self in the middle of all they do. She is passionate about helping women to unhook from feelings of guilt or fear, and encouraging them to develop a deep satisfaction in who they are and how they live life. Angela has extensive experience working with women and adolescent girls, as well as couples, to reestablish relational wholeness and build personal fulfillment. To find out more about Angela click here.

What’s one of the most common problems I see with students and recent grads? They have trouble getting their paperwork done! I’m the Quality Assurance Manager for a community mental health agency and it’s my job to make sure I give all our students and therapists the best tips and tools to make the documentation part of their job easier. I know, I know, you thought my job was to make their lives miserable, right?

As a student or a recent graduate you usually have external requirements for your paperwork. You have deadlines, you have people reviewing your notes, and someone else has likely chosen the template for you. If you’ve had multiple supervisors you’ve probably also gotten disputing opinions on how much to write and what should go where. But I’m sure you also got one overarching message- get your paperwork done on time!

Easy Tips for Timely Documentation

Here are some easy tips for getting your paperwork done on time. You can start using these right away. Warning: Not every method works for every person! Be disciplined about sticking with a method for at least two weeks and then evaluate whether or not it’s working for you.

1.Write in chunks. Some people are able to see a client for 45 minutes, write a 10 minute note, see the next client for 45 minutes, etc. If you can, stick to it and more power to you! Most of us aren’t able to do that, though. An alternative is to write notes in chunks. For example, see 6 clients on Monday from 11am-5pm and then spend an hour writing notes for all those clients. The time you select will depend on your schedule and flexibility, but try to keep it within 72 hours of your session so you don’t get backed up or forget what happened. When I worked at an agency I always scheduled assessments in the morning and made sure my afternoon was clear so I could finish it that same day (and then it was off my plate!). For regular sessions, I often saw clients in the late afternoon/evening so I didn’t want to stay until 8pm writing notes. I would schedule an hour or two in the mornings the next day and do all my previous day’s notes then.

2.Be consistent. Regardless of whether you write in chunks daily, every other day, or hourly you have to be consistent! Missing one day’s notes means adding an extra 60-90 minutes on the next day you come in. Find the schedule that (realistically) works for your lifestyle and then write it in your calendar. Documentation time has to be kept as sacred as a client’s weekly appointment time and your lunch break or you’ll always find other things to do.

3.Create a plan to catch up. If you do get behind in your notes (and most of us do, at some point or another), the workload can spiral out of control very quickly. Be honest with yourself and create a plan as soon as you notice the problem. A common mistake new therapists make when catching up is neglecting their current notes to complete the older notes. This keeps them in a constant battle of catch up. Stay consistent with your current notes schedule and make additional time in the short-term for writing the overdue notes. Start with the oldest notes and just move forward until they’re all done. Once you catch up, you’ll be glad you stayed up on your current notes and you can get right back to your regular schedule!

4.Get support. If you’re having difficulty figuring out which schedule works for you or find that writing notes seems to take you longer than your colleagues, seek out help from your supervisor. Tell them your struggles early on so you have someone to keep you accountable as you problem-solve. Also, talk with colleagues to find out what strategies work for them. It’s great to stay connected with others so you know your struggles are normal and you can also find others who have worked through them. If you’re not a part of the MFTGuide Facebook group, click here to join and connect with likeminded therapists who are making the transition from student to working professional.

Follow these tips and you should be successful in completing your documentation on time! I know it’s not the most exciting part of what you do, but it’s just as necessary as being present during sessions. If I’ve learned anything from reviewing hundreds of client charts it’s that timeliness has a significant impact on the quality of documentation. I can tell when a therapist wrote an assessment or progress note within 24 hours and I can definitely tell when they waited 24 days!

As therapists, we deal with such ambiguous but powerful feelings and ideas. Much of what we do is intangible and it’s sometimes difficult to put into words. Combine that with the stress of studying for exams, dealing with client crises, and lapses in memory over time and you have a recipe for disaster when you procrastinate writing notes.

If you’re looking for more tips on time management and making documentation more relatable to your clinical work, check out my free online training: The Private Practice Paperwork Crash Course. Regardless of what stage you are in your career, there are helpful tips that apply to therapists working in all settings. Now, use the strategies above and map out your plan to get your paperwork done in no time!

Dr. Maelisa Hall of QA Prep

Author Bio:

Dr. Maelisa Hall is an expert in clinical documentation who loves teaching therapists how to create rock solid documentation so they can spend more time focusing on their clients and less time worrying about paperwork. Click here for instant access to her Private Practice Paperwork Crash Course for mental health professionals.

I have successfully built a cash pay psychotherapy practice from scratch on
a shoestring budget. I have also failed a licensed exam by 1 point (only to
have the licensing board send me a later months later saying I passed),
started an online study group to ease my own isolation and have now reached
thousands of therapists across the country, helped other therapists market
their psychotherapy practices, and helped awesome business owners move from
close to closing their doors, to being profitable in less than 6 weeks.
I've failed at launching online programs. I've had wild success at
launching online programs. I've made mistakes in private practice I've
taught others how to avoid my mistakes. You can do this. You were called to
this work. Now- go do it! Find some help or inspiration as you need it- but
do the work!

There is little more devastating for a therapist than failing a licensing exam. The only way to be taking a licensing exam is if you have spent years being successful taking exam. SATs, GREs, Mid-terms, finals, exam papers... you have to get past all of those to even come close to sitting for a licensing exam.

If you have failed a licensing exam, you are not alone!

And you don't want to hear this- but it's not the end of the world. In fact, I'm extremely grateful for my experience of failing my licensing exam. So today, I wanted to give you a few tangible tips of what to do after failing your licensing exam:

1. Be kind to yourself.

Nobody will be harder on you than you will be. 99% of your colleagues will not think of you any differently, and will have compassion for your experience. Your colleagues know you are a good therapist from working with you- a silly exam isn't going to change that.

2. Take a rest.

The preparations you made up to the day of your exam were probably exhausting. Your body and mind truly need rest before you will be able to make sense of all of this and make a game plan to pass on your next attempt. Now is NOT the time to make any long term decisions.

3. Celebrate.

You took the exam. You made the attempt. The are therapists out there avoiding this exam like the plague- afraid of failing- you did it- and guess what- you are still standing! And you still get to do therapy. And you still get to be you!

4. Explore your anxiety.

There is nothing people hate more than me letting them know that the biggest preparation they need to be successful on their next attempt is anxiety reduction. I talked to a wonderful woman who called me for exam coaching after she failed her exam by 1 or 2 points. We talked about what happened- turned out her child had to be rushed to the doctors at 2am... and she had gotten some pitiful amount of sleep.

Guess what I told her? She is fine! She needs to do very little to prep- missing by 1 or 2 points on no sleep after your child's sick is fabulous! Now, she just needs to watch the anxiety the next time she takes the exam and realize that the first exam experience was not representative of her ability to pass the exam.

5. Reach out to community

Connect with great people. Be social. Have fun. Use this as opportunity to build some great connections and network with other people. You might just meet some of your favorite humans through this experience.

6. Take your power back.

Tap into your strengths, take care of your body, your mind- and make a game plan to pass on attempt #2. You can and you will do this!

I have successfully built a cash pay psychotherapy practice from scratch on
a shoestring budget. I have also failed a licensed exam by 1 point (only to
have the licensing board send me a later months later saying I passed),
started an online study group to ease my own isolation and have now reached
thousands of therapists across the country, helped other therapists market
their psychotherapy practices, and helped awesome business owners move from
close to closing their doors, to being profitable in less than 6 weeks.
I've failed at launching online programs. I've had wild success at
launching online programs. I've made mistakes in private practice I've
taught others how to avoid my mistakes. You can do this. You were called to
this work. Now- go do it! Find some help or inspiration as you need it- but
do the work!

The day/night before the exam

Select clothes you will wear (no pockets, hoodies, scarves, etc). Layer, so that you will comfortable, not be too hot or cold.

Try to take your mind off of the exam

Visit with friends

Have a massage, pedicure

Exercise

Go to a movie

The day of the exam

Give yourself plenty of time to get ready

Try to eat something nourishing, and sustaining

Meditate

Exercise/Stretch

On the way to the exam

Grab all the things you set out last night

Leave earlier than you need to, this will allow you to chill in the car when you get there

Listen to motivating music on the way (your favorite, or the theme to Rocky)

Tape the word PASS onto your dashboard and realize you will be seeing this at the end of your test

When you begin the test

Before you start, ground yourself, feet on floor, look around, touch the desk

If you feel it will help, use the ear plugs or noise cancelling headphones

Write your affirmations at the top of your paper to use as reminders during the test

Jot down anything you are worried you might forget (DSM timelines or such)

If you feel the need, write down some time markers for yourself for completing so many questions by what time (ie by the first hour I will be done with 50 questions…)

After the computer practice test, reground yourself before you begin

Stay present with the information, pretend you are in the room with the client or doing a case consultation. What would you do?

Make sure to take your break, eat your snack or drink some juice

Take the test in chunks, 20 questions at a time, Tell yourself, ”Ok I’m almost there”, as you near the end of each sections, then stop and close your eyes or look away from the computer, do a few eye circles or rolls

Pretend the stem is a puzzle to solve, read it first and before you look for the answer, ask yourself what you would do

Take the stem literally, do not read or assume more info than is given

Do not take time to read the DSM 5 questions if you are taking it before 1/1/15, these do not count, so don’t waste your time. If you want to, mark something and move on

Mark the ones that feel hard or that you are unsure, if you want write down the ones you think you might change later on your paper. You can key these in at the end and take another look.. Jot down the two answers you have narrowed down to, so you do not have to read them all again later

Remember there are experimental questions on the test. If it seems impossible, it probably is, and does not count

Mark an answer for every question. At the end of the test look at the top of the test to make sure you didn’t leave skip or leave any unanswered. There is a button for “unanswered” questions. If you did, go back and put something in, even if it is a guess

Go back, if you have time, to check only your marked answers, only change them if you are sure you made a mistake and have the “aha” factor of knowing it was wrong. Leave all other choices alone, your gut was most likely right.

After the exam

No matter what the outcome, remember this exam does not define you as a therapist

Celebrate your success at having come this far and having worked this hard

If you passed, take some time to rejuvenate and get ready for your next exam

If you do not pass, consider how much you learned from this experience, and how much more prepared you will be next time

Remember you are not alone. Connect online to others, take it one step at a time. Good luck!!!

Melanie Masters, M.A., MFT Intern has completed her Standard Written Exam, and is in the process of preparing for her Clinical Vignette Exam. In addition to being a MFT Intern, she is a Learning Disabilities Specialist at Moorpark Community College, where she teaches Study Strategies and does counseling and testing for learning disabilities. She specializes in working with ADHD and Learning Disabilities and hopes to be able to re-open her practice in the Thousand Oaks/Westlake Village, CA area as soon as she completes her licensing.

Melanie Masters, M.A., MFT Intern has completed her Standard Written Exam, and is in the process of preparing for her Clinical Vignette Exam. In addition to being a MFT Intern, she is a Learning Disabilities Specialist at Moorpark Community College, where she teaches Study Strategies and does counseling and testing for learning disabilities. She specializes in working with ADHD and Learning Disabilities and hopes to be able to re-open her practice in the Thousand Oaks/Westlake Village, CA area as soon as she completes her licensing.

While this blog is mostly focused on what happens AFTER you start your graduate degree in Psychology or Marriage and Family Therapy- I've been getting more questions about how to choose the right school if you want to be a counselor, MFT, social worker, or therapist.

Questions like:

The closest on campus school is 1.5 hours away. I could go to one school that’s accredited according to the MFT website. However, there is another school, Liberty Univ, that gives a discount to veterans(me). But I’m nervous that its not accredited and practices may not want to hire me because of that. Is that critical in my decision. Online would be better for me. Going with Liberty would also be thousands less expensive.

and

I am considering programs for my Masters in MFT. I am considering 2 online programs and since you are a consultant in the field i thought you may be able to shed some light on the topic of online education for MFT’s. The 2 programs I am considering are both COAMFTE Accredited and meet my states requirements. do you know how important the school you get your degree is? is there professional sigma attached to either Capella or North Central University? Or are the therapist’s internships more important?

These are wonderful questions to be asking prior to applying to grad school. I want to give you a few tips for choosing the right graduate school for you- in no particular order. I also hope that some of the other people in the MFTGuide community will post their suggestions in the comments below:

Explore the benefits of accreditation:

I didn't go to a COAMFTE accredited school-GASP! Honestly, when I applied to graduate school- I was completely lost. I didn't know that about additional accreditations and chose the school that was closest to me and that fit in my budget. Was it the end of the world? No. Did it have some drawbacks? Yes.

COAMFTE Accreditation

If you are planning to move around the country and want to be a MFT specifically- I'd consider springing for the COAMFTE accreditation. When it comes to licensure as a MFT- it is a state by state process. Many states see COAMFTE as a national standard and it can make the process of getting licensed in those states a little less complex. In other words- you won't need to submit syllabus of each class you took in grad school.

While we are at it- keep those syllabus. I know it sounds crazy. I wouldn't have EVER considered that they would be useful for anything- but scan them in- put them in a file so you have them in case anyone asks during the licensure process. Your grad school should keep them on file- but it can be a pain to get them to send them to you sometimes.

Has my ability to earn an income been stilted by not going to a COAMFTE program? No. However, I'm self-employed. In my particular area of the world, there were few COAMFTE programs- and it wasn't a determining factor when I was out in the job market. In your area- it might be. Check it out, make some connections- you might even find a local mentor along the way!

Check out the job market for therapists in your area

Go and look at the job descriptions of positions in your area that you would love to have. What do they ask for? Is it considered a "desirable" qualification to have a specific accreditation- take that into account when choosing schools.

While you are at it- see if you can schedule a quick chat with a supervisor or employee at your dream job. You might even pay them for an hour of consultation (very much worth it)- and find out what the market is for internships in your area. Will that make the difference in getting a paid internship?

Or, will you simply have an extra 100k in students loans and still be working for free? I know wonderful people who paid to have an EXCELLENT grad school education- who still couldn't find paying gigs out of grad school.

How easy is it to get an internship?

To be honest, my biggest questions that I would be researching would be related to the relationship the college has in the community with internship sites, the % rates of employments of graduates, etc.

In some cases, you may be better of going to a state school at a low price, and investing that additional 50k in advanced training and certifications like getting trained in EMDR, Emotionally Focused Couple's Counseling, DBT, etc. These advanced certifications will also give you more hands-on expertise for working with clients in the real world- which will make you a better therapist!

Get an internship now

Ok- not exactly possible in most cases. However, I'd recommend trying to move into a paying job related to the field asap. It isn't always plausible- but even volunteering 5 hours a week with a local non-profit while working your Full-time gig can put you miles ahead of your classmates when you interview for practicums, internships, and jobs.

I was lucky to grab a job at a local non-profit right as I started graduate school. My boss at the insurance agency I worked for, handled the non-profit's insurance policy. He gave me a glowing recommendation which helped in making such a drastic shift! Never underestimate the power of personal relationships and connections!

What about online vs in-person graduate programs?

The truth is, our world is changing. The biggest concern employees have related to your degree program is its preparation for you to do great work. I've seen in-person programs be therapy mills, and some REALLY cool online programs. However, whether in-person or online- you need to immediately find a place to start implementing what you are learning. The sooner you start working in the field- the better.

It won't just change your job prospects- it will transform the way you take in information. Your questions will be at a different caliber than your classmates, you can start to develop expertise before you ever graduate! I remember shortly after I graduated a professor coming to me to consult on a domestic violence case. I was shocked- but she knew from having me as a student my passion, expertise, and knowledge in the area.

Ok- so this is getting LONG! I might have to do a follow-up- I feel like I have SO much more to share! If you have particular questions- or want to share your tips: Share them in the comments below!

I have successfully built a cash pay psychotherapy practice from scratch on
a shoestring budget. I have also failed a licensed exam by 1 point (only to
have the licensing board send me a later months later saying I passed),
started an online study group to ease my own isolation and have now reached
thousands of therapists across the country, helped other therapists market
their psychotherapy practices, and helped awesome business owners move from
close to closing their doors, to being profitable in less than 6 weeks.
I've failed at launching online programs. I've had wild success at
launching online programs. I've made mistakes in private practice I've
taught others how to avoid my mistakes. You can do this. You were called to
this work. Now- go do it! Find some help or inspiration as you need it- but
do the work!

Therapists sharing important information and getting answers to specific questions that can really help them succeed!

Ultimately, it is simple a place where we've somehow attracted thousands of awesome counselors, marriage and family therapists, social workers and more into one place. Everyone has the same basic goal: Help and be helpful- and it works!

It sounds silly, but my favorite example today are people sharing that there is a heating and cooling issue in one of the California testing sites. To be honest, I wouldn't have ever considered calling a testing center to find out if they were having an issue, or been prepared for it being NINETY degrees in a professional testing center!

I'd be prepared with warm clothes for the traditional ice box that is testing centers- wouldn't you? But, several people have shared that this has been an issue for several weeks, people have dressed in summer clothes (in the Fall) just in case- and some have been able to make the determination to drive a little farther to take their exam so they could be more comfortable.

Those little gems make me SO happy! The study group that I started out of my own selfish needs back in 2005 is more than I ever imagined, and here it is 10 years later provided support and encouragement to people who are looking for study materials, therapists who have failed the written licensing exam and don't know what to do, and therapists who just need a community to keep them inspired!

How are you creating community in your life? How are you being helpful? Where are you getting help? Sign up for the free online study group today if you need some awesome community!

So let's talk about the 5 steps to building community as a pre-licensed therapist. Realize that the work you do NOW to build an awesome community- will also build up your professional reputation and help you when you start a counseling practice!

Be on the lookout for a great community. Look, search, and be dogged about finding people you can trust to connect with.

Start with clear boundaries as you watch and learn the culture of the group, and determine how safe it is to be "real" in the group (online or offline).

As you find safe places, be bold, brave, and authentic!

Be a safe person for other people- hold what people tell you in confidence, be helpful, empathetic, and model what you'd want from others.

Don't be afraid to "keep looking" if your first attempts at community building lead to some disappointments.

Let's create more community! That is how we are therapists grow, develop, and stay inspired (just like we did in grad school!). Share your ideas for creating great community below!

p.s. I'll be in Seattle, LA, and San Diego in November, and have free trainings every month on all aspects of starting a counseling practice. Check out the upcoming events here.

I'm so excited to be interviewed by Joe Sanok, LPC from the Practice of the Practice podcast! He interviewed my business partner and I about ZynnyMe and growing private practices. However, I got to talk about how failing my exam by 1 point was really the jumping off point for me in learning how to authentically grow a private practice (even though I didn't know it at the time!)

The California MFT Licensing exam, and several other state licensing exams for LCSW, LPC, Psychologist make a clear distinction between our legal requirements, and our ethical requirements. For many pre-licensed, and licensed individuals the two can easily get jumbled together in the carrying out of our daily duties.

In addition, sometimes, cultural norms within our professions can be perceived as ethical duties or legal requirements- when there is no such requirement. Not only can this hinder us when attempting to pass the licensing exams- it can be confusing in our future independent clinical practice. And that is what licensing exams are about- it is the licensing boards best effort to ensure we are ready to practice on our own without forced oversight.

I wrote an article for ZynnyMe about Is it Ethical for me to ________ in private practice? While the questions I answered might not be on your mind for a bit if you aren't in private practice yet- definitely check out the recommendations for developing a clear understanding of your ethical obligations, and developing your own personal code of ethics!

Here are some of the questions I cover:

It is unethical not to accept insurance.

It is unethical not to offer sliding scale to everyone who calls you.

It is unethical to charge a certain fee.

It is unethical to hire contractors to work within your private practice- no matter the situation.

It is unethical to refer a colleague to any other business if that business offers any sort of thank you, or perk, for that referral.

It is unethical to offer coaching if you are a licensed or unlicensed therapist.

It is unethical to start to market or brand yourself prior to licensure.

Did you know that one of the things people search this site for is free study materials? The ethical code of your professional organization is one of those free study guides! Go and read it, soak it in, understand it- it will help you prepare for your exams and doesn't cost a dime!

So excited to have the wonderful Maria Shufeldt submit an informative article outlining the process for applying for accommodations. Give it a read, explore, and become informed about the options and process for asking for special accomodations when taking licensing exams in California.

State and federal laws require the BBS to give exam applicants with documented disabilities an equal opportunity to perform on the licensing exams. Disabilities are generally defined as a condition or impairment that limit one or more major life activities. They may also include mental or psychological disorders, and specific learning disabilities.

If you believe your test performance would be affected by such a condition, you may file a written request with the BBS at least 90 days before scheduling your exam. The BBS will evaluate your eligibility for “Special Accommodations” within the legal mandates.

Accommodations must fall within certain limits, and may not alter the exam’s measurement of knowledge or skills. Specific accommodations approved will depend on BBS evaluation process, and may include: up to time and a half for exam completion, a private room, breaks to take care of special needs or use management strategies, or special equipment like seat cushions. You may also request to take the test by pen and pencil.

A request is another form of application to the BBS, so make sure that you are timely, accurate, and thorough. Be patient: it’s the BBS, after all! Here are some steps that may help during the request process. I used clinical terms because it may help to remember this is a systemic process. Keep focus, not frustration in mind.

1. Assess yourself, the situation, and the presenting problem.

Assess how all the bio/psycho/social factors of the testing process may affect you if you have a pre-existing condition. Try to visit the test site to assess the environment and ask questions of the facility staff. Think carefully about your daily functioning, and compare that with the exam conditions.

2. Refer out for expertise

Consult with a qualified medical or educational professional as soon as you determine you want to request accommodations. BBS requires testing and/or medical diagnosis, and will consider the length of time you have been in treatment, as well as requirements and recommendations for management during the exam.

Some conditions may not qualify if corrected by aides or medication. (Examples: wearing eyeglasses, or taking ADHD meds). Finally, keep “test anxiety” out of your mind and vocabulary. It is not in the DSM.

3. Advocate for yourself.

This is what we do ethically for our clients, but can be difficult for ourselves. Finally getting to exam stage requires many sacrifices and admirable qualities such as persistence and self-sufficiency. Yet the exam is not the time to “white knuckle” a known condition, hesitate to request assistance, or to ignore the possibility that a disability or non-diagnosed condition is affecting you. Remember (as if you didn’t know): it’s a 6 month wait to retake the exam.

4. Recognize (and keep) your role in the system

BBS follows its own defined process within the legal mandates of Special Accommodations. Here is what you should expect – in order of likely occurrence:

Submit your Request for Accommodations to the BBS Special Accommodations Specialist at least 90 days before scheduling your test date.

The BBS will evaluate your request and mail you a letter of official approval with specific accommodations. You can check on status by phone or email to the BBS Specialist.

If your request is approved, BBS will send you a letter that specifies your Special Accommodations. You will schedule your exam by phone only with PSI’s Accommodations Unit only. When you call, ask PSI if they have received an upload of your accommodations approval from BBS. You cannot schedule until this is in place. You can follow up with BBS and/or ask PSI to call you when it is received.

Once you are scheduled and starting your study process, you may want to ask your test coach how to incorporate accommodations in your mock exams.

On test day, be sure to bring everything you have been allowed for your accommodations, including the letter of accommodation from the BBS.

Generally, BBS will apply approved accommodations for the 1st. You will receive another mailed letter for the second accommodations, and you should follow the same steps outlined above.

1. Confidentiality and Disclosure

BBS maintains confidentiality on your Special Accommodations status, but you will make the decision yourself about disclosing to colleagues and friends or family. This decision generally comes up when people ask you “how long did it take,” or other details about the testing conditions.

Did you know that therapists are imperfect people?

Shocking- I know! We all come to this profession down a different path- and we all have our baggage that we bring with us. Becoming aware of our "stuff" and doing our own work is often an important piece of being healthy and effective ourselves. Just one reason why doing your own personal therapy work can be so powerful as a therapist.

However, personal therapy work isn't always required, and just because we experience therapy- doesn't mean we are ready to be transformed from it. Getting licensed as a therapist doesn't require a clean bill of emotional health, nor does being emotionally unhealthy keep you from becoming a clinical supervisor.

What do you do when your clinical supervisor is struggling?

I remember going into my first meeting with a clinical supervisor and feeling completely out of my depth and unsure. I had no sense of choice, no direction, and I had no idea what to do. My poor clinical supervisor was overworked, overscheduled, and mentioned that she didn't know how or when she would fit me in.

I left the meeting feeling disheartened and lost. She was a wonderful clinical supervisor, always made time for me- but I remember feeling rejected and unwanted in that first meeting. Now I know this was my own stuff coming up. At the time, I remember not even being sure if she was going to have time- thinking maybe I wouldn't have any supervision at all. She wasn't anything like that. She was an amazing supervisor in SO many ways!

I was blessed to have a simple misinterpretation or misunderstanding when meeting my first clinical supervisor. However, I've heard more than a few stories that were far from misunderstandings or misinterpretations. So, what do you when clinical supervision isn't going so well?

Here are some steps to take to get out of a nightmare clinical supervision situation:

1. Start to write things down

Start to write down what is happening. Consider keeping a journal that just has dates, times, incidents, and a second one where you explore your thoughts, feelings, and reactions to the situation. Make sure to create a balanced list and include any good experiences you have with your supervisor.

Best case scenario, this will help you create some distance, and explore if there are areas that you will need to grow in- self-advocacy, boundary setting, verbalizing needs, etc. You may become aware of some misinterpretations you are having, or aware that your clinical supervisor isn't perceving you accurately. What is the best thing to do when someone isn't getting an accurate picture of you? Model who you truly are. Feelings of defensiveness don't bring out the best parts of me, and they may not bring out the best parts of you. Take care of you, and try to get into a calm state where more of the real you can come out.

Worst case, this will be documentation if things go too far south.

2. Explore your part without blaming yourself

In a true nightmare or bullying situation, people commonly take 100% of the blame for the nightmare situation. Start to work out areas where you do have options, power, control- areas where you can grow-without taking responsibility for the other person's behavior. Best case you find that this is just a rocky start to the relationship, or you grow in some areas that will help you in your clinical practice.

Worst case, you will come to a realization that you've done all you could, conducted yourself with integrity, did your best to solve the problem- and that you can move on with no second guessing or inaccurate levels of self-blame.

3. Explore your supervisor's part without villianizing them

I didn't even realize when I started my practicum and internship that I had somehow put my clinical supervisor on a pedestal. I assumed that the things they told me were absolutely right 100% of the time. Truth is, supervisors are infallible just like the rest of us. As a clinical supervisor, I modeled for my supervisees the skills I wanted to take with them- like calling for legal consultation- or looking up documentation. I didn't just tell them what was right, or what I wanted them to do- I showed them the processes that I used and helped them practice the same process. Why? Because I don't want my supervisees to put me on a pedestal- I want them to learn good judgment skills.

Explore multiple perspectives and try to view your clinical supervisor as a human. Have they ever been a clinical supervisor before? Are they feeling unsure or anxious? Are they overwhelmed personally or professionally? While you these may not be excuses for poor behavior, creating a sense of understanding can sometimes lead to resolutions of issues.

Worst case: Think of this as practice in your work analyzing people's patterns or behaviors and creating a sense of separation.

4. Finally, look for ways to create options and movement

I've seen particular non-profit, agency, and for-profit organizations where there is very little room to get support or feedback if there is a big issue. Create options for yourself by networking, looking at alternate jobs, and reaching out for support within your organization.

No matter how nasty the situation is with your current supervisor, focus on developing ways to avoid bad-mouting or complaining about your current supervisor. Find a true way to talk with joy about what you have learned, and to verbalize what you are looking for in your next position. If you aren't already in therapy- consider getting a therapist. Therapy can be an amazing experience to help you keep things in perspective- and any type of nightmare or bullying situation is sure to bring some stuff to the surface- why not use this as an opportunity to get this stuff taken care of in therapy?!

What about your? What advice do you have for peope in nightmare clinical supervision relationships? Share your advice and comments below!

p.s. I'm really excited and proud to be co-leading the next Business School Bootcamp for Therapists. If you are looking for support in building a private practice- click here.

It is interesting to me that many therapists either put too little emphasis, or too much emphasis on licensing exams. While I don't believe most people benefit from "studying for the exam" for an extended period of time (it can lead to burn-out, overwhelm, anxiety, and test trauma)- I do believe in preparing for the exam over an extended period of time.

From the moment you enter graduate school, and maybe even before that- you are preparing for licensing exams. Your exams cover cumalative material that you will learn, experience, and practice in the several years it takes to finish your degree, finish your supervised hours, etc.

If you are a student, an intern, or a clinical supervisor- I highly recommend you locate the list of topics that will be covered on the exam today. Not so you can start studying years or months in advance- but so you can start expanding your awareness.

Look over the list for fun topics that interest you, or that relate to your current caseload. Bring those in to your individual or group supervision. Find books that inspire you, talk about these things in a way that isn't stressful or anxiety producing. Get confident knowing that you have the knowledgebase and theoretical background, play with the clinical expression of the material...

When you are ready to schedule your licensing exam, study materials should simply be about filling any remaining gaps in knowledge, developing confidence in the expereince in actually taking the test, and learning strategies to translate your face-to-face clinical knowledge and judgment into a pencil and paper setting!

But wait! I hear the exam in California is changing, or the national MFT exam is changing. What do I do? Breath. There will be some changes on the 2015 version of the exam (unless they push it back again). Understanding the DSM IV and the clear changes to the DSM V won't be a waste of time. It is important for you to understand the history of diagnosis as you talk to new clients.

For example, I have clients who still refer to themselves as manic depressive- even though that isn't listed in the DSM. It is important to know the history- so I clearly know they are talking about Bipolar disorder! Remember, this is your career path, your passion- NONE of this will be wasted time or energy!

Have you joined our free online study group for exams yet? Subscribe to the newsletter to get your invite and your free podcasts! Are you burnt out on exam studying? Clear your mind and start dreaming of private practice- we've got some groovy free trainings over http://www.zynnyme.com including our newest live training- how to develop your specialty!

I started a blog in March 2013 without really knowing where I was going to go with it. At the time I was considering family/parent coaching as a way to build my name before I was licensed. I was also having tons of conversations with professionals who would really dig what I was saying about parenting and how to help parents. So, I started blogging and directing people to my blog as another way of networking. As I started writing more, I began to develop my voice and began to see that I had a ton of information to give to others. I also realized that I was really getting to know my niche.

So, how did I start blogging as pre-licensed therapist?

I started with a free WordPress blog and I committed to writing one blog a week titled The Weekly Skill, since I was focusing on parenting developing their parenting skills. After I got the flow of blogging, I also committed to doing one series blog a month (i.e., do a series on parenting concepts posting one in the series a month). I created a schedule of how the series would span out over the next year (so, this was May 2013). With that schedule set, it gave me motivation to begin this task of getting my ideas out of my head and onto “paper”!

Beginning the blog with a schedule set for how I would post made it easier to digest and I felt more confident that I could actually pull this off. But, it did feel like a lot at the time because I was still in my full time community mental health position. As I began to network and share my posts, I began to get feedback that people were not only sharing my posts, but they liked them! And, that was great motivation.

Now, why is this a good thing for you?

How can blogging benefit ACSW and MFT Interns while accruing hours (or waiting on hours to be approved)?

Well, I’m glad you asked.

Here are 5 ways that blogging is great while you are pre-licensed:

It gives you a space to carve out your niche, or ideal client, well before you break out on your own.

It can help you get your ideas and thoughts about helping clients sorted and organized a. Note: When I first started my blog in 2013, I just wanted a place to put my thoughts about parenting out and keeping them from being unorganized in my mind

It allows you a creative space to develop your voice without the pressure of solely marketing to client.

As you write, you will begin to nurture the confidence in how much knowledge you have about working with your ideal client, or within your niche.

It’s also a great place to for others to find out about who you are. a . It can be used in connection with your other social media profiles to give a whole picture about you and your work!

It let's Google "get to know you" so when/if you launch a private practice you won't be starting from scratch!

Now that you see the benefits, and understand how having a blog can add value to your work and development as a clinician, what can you do to start blogging?

Blogging Tips for Therapists Starting Out

Pick a platform

WordPress.com and Blogger.com are two of the most prominent blog platforms, and I would honestly start there. Both platforms have free accounts so you can begin immediately. The benefit of using either one of these platforms is that there are tons of help on forums, Google, and Youtube to help you get started. But, to be honest, the simplest way to begin blogging is to sign up, pick a cool theme, and start writing!

Decide on a schedule

One of the biggest barriers that I have heard from other prelicensed clinicians about blogging is knowing when to blog and how much to blog. The short answer is that it’s really up to you; do whatever you feel is comfortable. But, the longer answer is that you should start with at least once a week for at least a year. I give this suggestion because you will see so much progress in your writing, inspiration, and voice if you write more. Essentially, the more you blog the more comfortable you will become.

Write about what you’re interested in

Of course, a pre-licensed blog should focus on helping clients, but also it should talk about who you are clinically and professionally. I recommend not worrying about focusing on an ideal client for each post just yet, but write about topics that interest you in the field (mental health awareness, gender roles and its effect on society, gay rights, advances in psychotherapy).

Find a blog challenge

There are a few cool blog challenges that are swimming around on the web right now. One that I used is from Julie Hanks’ Private Practice Toolbox blog (you find the challenge here). These challenges give you inspiration for thinking about blog topics that can really get your creative juices flowing. It can be difficult to think about relevant topics sometimes, so having a list of topics that you can chose from will help with the writer’s block or the barriers that come with writing your blog.

Don’t worry and have fun

Lastly, just have fun! Blogging does not have to be stress inducing or anxiety provoking. Understand that you’re not building a website yet, and you’re not worried about SEO, search engines, or marketing yet. And, look eventually you can link it to your website, but right now, just enjoy!

Here’s a little bonus, you can add a separate page to your blog and add your resume/curriculum vitae. By doing this, you can send the blog link to potential supervisors or add it to your email signature when you’re looking for an internship. It will give them a good picture of who you are as a clinician and they’ll be pretty impressed too (trust me!)

Overall, blogging can be a real benefit to your prelicensed journey if you are willing to use the steps above and use it to enhance your already impressive skill set.

Happy blogging!

*A huge thank you Mercedes Samudo for reaching out and offering help to other MFT Interns and ASCW who are the journey to being licensed as a therapist. Check out the awesome resources she provides parents at http://theparentingskill.com/ This may be a great resource for the parents you work with who are struggling, or parents of children that you are working with!

Many pre-licensed therapists and student therapists enter a graduate program with the express intention of working in private practice.

Unfortunately, not many (if any) psychology, counseling, or social work programs are developed to prepare you for launching a private practice. The focus for most psychology students and graduate students is "after I'm licensed I will..." The vision is that once they go through this strenuous process of licensure- the other pieces will come together.

I help licensed therapists market their psychotherapy practices daily. And guess what? The process of getting licensed doesn't necessarily prepare you for the process of opening a private practice successfully.

Good news for pre-licensed therapists who plan to go into private practice!

Here is the good news. Actually, here is the great news. The process of preparing for private practice WILL make you a better therapist, counselor, or clinician. How cool is that? In fact, the process of preparing for your future private practice might even help you gather hours faster, develop a better clinical intuition, navigate the process of licensure with more ease, pass your licensing exams, and get paid better!

Preparing for private practice WILL make me a better therapist?

Ok, that might be a bit of an over-statement. If you prepare for private practice the right way, I believe it will. Here are just a few ways you can prepare for a future private practice and how it can make you a better therapist now and in the future:

1. Successful private practices have referral sources.

Now, this might sound simplistic, and redundant. Stick with me for a second. In order to have a consistent pool of clients, people have to know you exist. Simply putting up a website, or sharing your business cards won't magically fill a private practice with paying clients. You need to be known. People need to know what you do, understand the value, and be excited enough to remember you and share your name with others.

How does this make me a better therapist?

It forces you to build relationships in your community. This doesn't mean you have to be an extrovert, or be on TV if that isn't your thing. However, you do need to build solid relationships with people out in the world. That means getting to know them as well. This means you will have more access to resources when your clients need them. This also means you are less likely to be isolated, stressed out about getting clients, and burn out in the future. All of that means you will be a better counselor!

2. Successful private practices understand their unique value.

I know you may have been taught in school about many theories, psychotherapy processes, evidence based practices, etc. However, here is the truth: You bring something unique to the table. I agree that in most cases, just bringing your "you-ness" without any background or training won't be clinically impactful. I also believe that really great therapists begin to understand why they are good at what they do, what they are good at, what they need to work on, and who they should refer out.

How does that make me a better therapist?

If you can't identify what you are good at, how you can identify what you aren't doing well in? If you don't believe what you specifically do as a therapist has value, why would anyone else believe that and pay you for it? If you don't believe what you do has value- will you be looking to your clients to validate your work? How will that impact your clinical work?

3. Successful therapists in private practice can convey their value to others

This may seem like a repeating of #2- but it isn't. Many therapists who understand they bring something deeply unique and valuable to their work- struggle to convey that in words to others verbally and in writing. This ability to convey our value in words is an extension, or sometimes even a precursor, to finding our deep clinical voice.

How does that make me a better therapist?

Seeing a therapist tap into, and settle into their deep clinical voice is like watching your child take their first steps. It is an amazing, beautiful, tear producing, scream in delight sort of moment. And hearing how that newfound confidence and peace transforms their work with clients- it is the stuff that makes my job awesome.

Have you ever met a therapist where it just feels good to be around them. When they talk about what they do- it makes you smile? That is someone who has tapped into their passion, into their clinical voice and they have the words and confidence to convey it.

I'm just an intern...

But, you don't understand... I'm just a student... I'm just an intern... I've got years for these things to naturally develop!

Truth moment: These will only develop if you give them attention. Just like we teach our clients, where we put our focus and energy is where we see development. If you focus your attention in these areas starting today, you will see major shifts between now and licensure. If you focus on simply "getting licensed" you will find you "get licensed" but not necessarily feel confident, be known, and know who you truly are as a therapist.

The coolest part? When you focus on these aspects of your development, you will find major opportunities will come to you. You will find out about jobs before they get posted online, you will get letters of reference that land you interviews, you will get people offering you opportunities that they just wouldn't offer to someone they didn't know and believe in.

Go out, get to know your community, let your community get to know you- and get to know and love yourself. All of these are pieces of successfully marketing a private practice now and in the future! Go! Be great!

Now, comment below what you will do TODAY to go out into the world and be great! And, of course, if you want more fun stuff like this- feel free to get on the list for free tip sheets, podcasts, and trainings geared towards the needs of pre-licensed therapists and clinical supervisors.

Getting a private practice internship isn't easy. And truth be told, getting one is easier than having a successful private practice internship.

What you don't know about private practice internships:

In California, and some other states, you are required to be a w-2 employee. That means you get paid for everything you do in the business.

If you don't have any clients, and you are spending 20 hours a week working to find clients- technically your employer should be paying you for all of those hours.

That is good right? Yes, and no. What if you spent 25 hours a week for 10 weeks looking for clients, or even just learning on the Internet, but you don't see any clients? Even if your employer/supervisor was only paying you $10 (a bit above minimum wage)- they have just lost thousands of dollars!

In addition to your pay, they have to invest in payroll taxes, insurance, worker's compensation, provide oversight, training, etc. They may have lot even more income in lost wages.

Taking on a private practice intern is a big deal and a bit of a gamble.

Most clinical supervisors don't have time to walk you through every aspect of getting clients.

But won't they just give me their overflow? What if their overflow doesn't click with you? What if you dont' instill confidence on the phone? What if you slide the fee everytime?

For a therapist in private practice who is primarily seeing clients as their income- they are looking to invest their time and energy into an intern who will be a good investment. You are kind of like stock! You need to show them that you have done some pre-work, you know your stuff, and you are ready to hit the ground running and you know how to not just do good therapy- but how to get good therapy clients.

A private practice internship will help you start your private practice

I know that can be overwhelming and anxiety provoking. However, it will be an amazing training ground for your future private practice. I recommend that anyone who plans to go into private practice in the future- start today!

Wait- I'm still getting my Master's degree- can I start today? Yes.

Wait- I'm not done with my hours- should I start today? Yes.

It may be a period of time before you can legally start seeing psychotherapy clients in private practice. However, that doesn't mean you can't start the process of growing a practice today.

What can I do as a psychology student or pre-licensed therapist to prepare for private practice?

Launch an online presence. Commit to blogging at least 6 times per year (I'd recommend 12) on the topics you are most passionate about. Bonus points if you already know what area you want to specialize in- write on those topics.

Launch a community presence. Commit to attending at least 6 trainings per year, and follow-up with 2-3 people you meet at each of those trainings after the event.

Develop a list of people to refer to. Get to know what people are passionate about- if they are awesome- refer people to them.

Start creating a vision for your practice and add in 3 business trainings per year- even if you don't think you will need it now. Start to create a mental foundation or schema for what building a profitable private practice will look like. Here is a free private practice 101 training you can watch today.

There are more things you can do to build a private practice- but let's keep it simple! Post your private practice internship questions below. Did you do something awesome to snag a private practice internship? Tell us about it!

Ernesto from http://www.fylmit.com/ was kind enough to interview me last week as part of his presentation to pre-licensed therapists about marketing a private practice. Give it a watch and find out what I shared with his classes to help shift their mindset about being a pre-licensed professional.

Yeah... I know.... the site is called MFTGuide... I get why you wouldn't think we have any connection to ACSW and LCSWs. To be honest, I let some really well meaning, awesome business advisors convince me to name my site mftguide... If I was to go back in time- I'd choose something else. Back to the point.

While the process that prelicensed therapists go through to get licensed is quite similar, and exam formats may be similar, the material can be quite different. It is important to choose study materials that understand the material that will be on the exam for your particular license. While I empathically recommend picking up a paid study program before taking licensing exams- I also believe studying for licensing exams should start in graduate school.

Ok... I'm not talking about stay up every night stressing and sweating for hours studying. I'm just talking about digesting material throughout your process of gathering hours that will make the process of preparing for licensing exams less stressful.

It isn't uncommon for interns and associates to realize, during the studying process that they had been doing some things wrong, or been misinformed for YEARS! Many say- I wish I would've known this at the start of this process.

One fun way (if you can let go of the text anxiety aspect) to start prepping is with free LCSW study materials online and LCSW study apps. I'm sharing these resources here as a fun way to bring material into supervision, consultation, or even into a monthly exploration of- wow I didn't know that! session.

BTA Exams Lite is a free program developed by a LCSW and professor at UC Berkely in California. It has 25 free questions and is available on Android and Iphone.